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The Fertile Future

This blog will address many of the common questions and concerns that couples and individuals express when considering whether to pursue fertility evaluation and treatment.

Dr. Eric Levens received his Bachelor of Science Degree in Biology from Indiana University and his Medical Degree from The University of Texas Medical School at Houston. He completed his residency in Obstetrics & Gynecology at the University of Florida. Dr Levens continued his training as a Clinical Fellow in Reproductive Endocrinology and Infertility at the National Institutes of Health. He is Board-Certified in Obstetrics and Gynecology and Reproductive Endocrinology. Dr Levens is currently seeing patients in the Annandale Virginia office of Shady Grove Fertility Center.

Prior to joining Shady Grove Fertility, Dr. Levens was a Lieutenant Commander in the United States Public Health Service and served as a Staff Clinician at the National Institutes of Health and the Walter Reed Army Medical Center. Dr. Levens has authored more than 50 publications in Reproductive Endocrinology and Infertility and is an Assistant Professor of Obstetrics & Gynecology at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.

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Welcome to my blog, The Fertile Future! I'm Eric Levens and I’m a board-certified infertility physician practicing at Shady Grove Fertility in the Washington, D.C. area. This blog will address many of the common questions and concerns that couples and individuals have when they consider whether to pursue fertility evaluation and treatment.

So let’s get started at the beginning! Many people are surprised to learn that infertility is a medical disease, defined as the inability to conceive after 12 months of unprotected intercourse (after 6 months for women ≥35 years of age).

For many having difficulties conceiving, one of the greatest hurdles is making the first step: Scheduling an appointment to see an infertility specialist. This is understandable, given so few other events in life are so deeply personal and, no-doubt, fundamental to our sense of self as our ability to reproduce.

As a result, making that first appointment to see an infertility doctor often seems like a gigantic leap. If you’re contemplating taking this step, it might be comforting to know the things that would likely occur at your first visit.

One question that comes up all of the time in my clinical practice is whether the risk of miscarriage is greater among women with PCOS.

Numerous studies have addressed this question, each with its own strengths and weaknesses. From my perspective, the most useful studies are those that identify women with PCOS and follow them forward (cohort studies) to see if the risk of miscarriage is greater compared to women without PCOS. One closely followed group of women are those undergoing assisted reproductive technologies (ART), as clinics are required by law to monitor the outcomes of IVF cycles.

Many couples have concerns about the effects of age and fertility. Reproductive aging has become an increasingly important issue as our society has experienced longer life expectancy, advances in assisted reproductive technology (ART) and a changing role for women.

As noted in an earlier blog Age Related Decline in Female Fertility, maternal age significantly influences pregnancy outcomes, with maternal fertility peaking between the ages of 22 and 26 years and starting to decline around the age of 32 years. The progressive decline in fertility is caused by a loss of both the quantity and quality of the remaining eggs. Consequently, women experience an age-dependent increase of miscarriages, obstetric complications and chromosomal abnormalities of the fetus (Down’s syndrome for example).

I cannot stress enough the negative impact of female aging on reproductive outcomes. Every day that I see patients in the clinic, I discuss the importance of the age-related decline in female fertility. I typically describe this as a case of "cruel biology," because for women, unlike for men, the passage of time is a treacherous adversary in terms of achieving a pregnancy and building a family.